Striving for their survival

Survival rates for paediatric cancer cases in Tanzania have tripled in the four years since Trish Scanlon from Wicklow arrived in the capital, writes
ELLEN BARR

PAEDIATRIC CONSULTANT Trish Scanlan says her colleagues in the Tanzanian hospital where she works refer to her as the “crazy Irish doctor”.

As the only children’s cancer specialist in a country with a population of 43.2 million, the Wicklow woman could be forgiven for being a little crazy.

When she arrived in the University Hospital in the Tanzanian capital Dar es Salaam in 2008, children with cancer were left alone in their ward for hours, unsupervised and untreated because there was no money to pay nurses to work nightshifts.

Despite the best intentions of dedicated staff, medication was scarce and children who were diagnosed had little hope of surviving. Survival rates for children diagnosed stood at 12 per cent compared with figures of 75-80 per cent of children in Ireland being cured of their cancer.

Fast forward four years and Scanlan, originally from Windgate near Bray, has presided over the tripling of survival rates for paediatric cancer cases in the troubled South African country. With more children receiving treatment than ever before, that trend looks set to continue.

While the news is positive, the energetic doctor continually finds herself in the middle of heartbreaking stories where parents have travelled for days with their child at death’s door. She says it’s the spirit and bravery of the children and the dignity of their parents which keeps her motivated.

“You see these kids coming in and they can’t walk or breathe and their bellies are so swollen and you really fear for them,” she explains.

“Sometimes I see them being admitted and I’ll come in the next day and the bed is empty. I’ll ask whether that child has died overnight and I’m often told that they’ve received treatment and are up and back at school. That’s how instant the impact can be when children get access to the medicine they need. Kids don’t want to be lying in bed. As soon as they’re able, they want to be up and about again. They are so so brave.

“When there are children we can’t save because they’ve come to us too late and we have to tell the parents, they are always so grateful and understanding. Their first reaction is always to thank us for treating their child because many of them have waited years for some help. They are amazing people.”

The affable 38 year old doesn’t see her role as an isolated one and says the support from colleagues at Our Lady’s Hospital for Sick Children in Crumlin has contributed to the saving of many lives in the humble hospital ward thousands of miles away in Dar es Salaam.

“Crumlin is where I spent most of my time training and I cannot say enough good things about the people who work there,” she says.

“They are unbelievably supportive – every single department – from the cleaning staff, library, clinical engineering, surgery, anaesthetics, pharmacy, laboratory, resuscitation training, medical consultants and nurses – they all give me advice, many have visited, helped fill in the gaps we have by providing their services and expertise and all completely free of charge. Our oncology ward is almost an unofficial outreach centre for Crumlin.”

While she also receives huge support from Irish charity Children in Crossfire, on a day-to-day basis the responsibility for dealing with the massive influx of paediatric cancer cases falls on Scanlan and the team she heads up. While hugely grateful for the help she receives from outside the country, the Bray woman acknowledges that her role is still anything but easy.

“I’m constantly under pressure, mostly to find and provide the best treatment options for the children but also just the constant pressure to get everything done in time, there is just so much to do all the time.”

While facilities have improved dramatically since she took over the running of the paediatric oncology ward, Scanlan concedes there’s much more left to do and that the gap between services in Ireland and Tanzania remains massive.

“One of the biggest differences is that most children still come very late,” she says.

“The village and town health services are still not adequate and there are many delays. Of course there are also lots of other differences even when the children do arrive. We still have multiple children on each bed. We still cannot afford all the drugs the children need. Emergency services on the ward level are poor.

“The laboratory still does not have the same number of investigations. There are far fewer personnel looking after the children, nutritional support and all other non-clinical supports including things like school and play therapy are nothing as sophisticated or individualised.

“In many ways we still have a long road to travel but we are certainly making progress.”

While survival rates for children diagnosed and admitted for treatment have rocketed since she arrived in 2008, the Wicklow paediatrician says she’ll stay in Tanzania until such time as she sees her job being done.

Already plans are in place for a custom-designed ward and a hostel where children and parents can stay during their treatment thanks to the support of Children in Crossfire.

Part of her role, insists Scanlan, is training other medical professionals to ensure that the standard of care and survival rates remain high.

“I will be here until I think the programme will be managed locally,” she says.

“One of our biggest projects this year will be the initiation of a fellowship in paediatric oncology so that home-grown local experts can be trained and they will then move the programme forward in the direction they would like.”

Until that’s achieved Tanzania’s only paediatric oncologist will fit in visits back to Wicklow when she can and is hoping a relaxing hobby she’s learning will help with the pressure of the job in the meantime.

“I sail a little and dive a little but mostly I just hang out with my friends. My brother is trying to teach me yoga, which would be very good for me I’m sure,” she laughs.

As for keeping motivated, that, she claims, is easy.

“The children are inspiring and delightful,” she says.

“I always say that if I’m having a bad day it’s only because I haven’t spent enough time with the children. They lift your spirits and make it all worthwhile. They make me laugh every day. I love them all.”

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